Wednesday, October 25, 2017 // The Statement
4B
Wednesday, October 25, 2017 // The Statement 
5B

SPINNING OUT OF CONTROL 

The balance between performance and body image

b y Yo s h i k o I w a i, Deputy Statement Editor

“

Forty 
kilograms,” 
the 
ballet 

instructor 
announces. 
Silent 

agreement among faculty and 

other students is palpable in the studio, 
albeit the obvious tension. It’s an easy 4 
kilograms below the number where the 
scale’s needle hovers — a sigh escapes, 
relief fills my chest. I step off and watch 
the needle bobble back to zero, a number 
I will never be.

This was my seventh grade. It was 

routine for me. After four hours of ballet 
every day, we weighed in and heard our 
“ideal” weights announced to the class, 
a public service announcement to spark 
incentive. A scale was kept under the 
piano, right by the accompanist’s feet. 
We were praised when we were under, 
condemned for every half-pound we were 
over. No amount of sweat — enough to 
wring from our leotards — was ever good 
enough. It was a balance between satis-
faction with the reflection in the mirror 
and having enough fuel in your body to 
get through the night. It was nothing 
short of destructive.

I kept this mentality with me, through 

boarding school and part of college after-
ward — the pressure to conform, the 
ever-present desire to be liked by a cho-
reographer, a teacher, a coach lingered 
in the back of my mind. In high school, 
I listened to my friends purging in the 
bathrooms, taking laxatives like candy 
and throwing away food without giving 
it a second thought.

The phases came in and out of my 

life, as they did for many of my friends 
in dance. It’s difficult to denounce a 
lifestyle that has been etched into your 
brain, diet and outlook on food. It’s con-
suming — present at every store, social 
event, relationship. You never realize 
how pervasive food is — the way it brings 
people together, maintains friendships 
and creates new ones.

It wasn’t until college and a pre-med 

curriculum that I found some peace 
with my body. Or made efforts to do so. 
The facts became harder and harder to 
neglect: anemia, brain defects, infertil-
ity, multiorgan failure. It quickly became 
apparent that the effects were long-last-
ing and severe. For the first time, it was 

real.

Over the past few decades, eating dis-

orders have been a topic of conversation 
on college campuses. Universities across 
the country have dedicated services spe-
cifically for eating disorder treatment. 
The University of Michigan offers help 
to students battling eating disorders 
through programs at University Health 
Services and Counseling and Psychologi-
cal Services, along with other smaller 
organizations and student-run groups 
like Wolverine Wellness and MBody. 
Michigan Medicine has a Comprehensive 
Eating Disorders Program, providing 
individualized care for patients between 
8 and 24 years old.

Dr. Terrill Bravender, David S. Rosen 

Collegiate Professor of Adolescent Medi-
cine, is a program physician and section 
chief of the University’s Comprehen-
sive Eating Disorders program. When I 
interviewed him, Bravender spoke of the 
college campus as a stimulant of eating 
disorders.

“If you think about it, if you’re at risk 

for developing eating disorders, college 
culture is perfect,” he said. “You’ve got 
rec centers that are open 24 hours a day, 
you have high emphasis on appearance, 
you have an opportunity for 24-hour-a-
day eating and all of a sudden as a college 
freshmen, you are responsible for creat-
ing your own structure in your life. All of 
these distractors can make people’s lives 
feel like they’re spinning out of control.”

Despite the prevalence and sever-

ity of eating disorders, there are few 
nationwide studies on the disease within 
college students. Although surveys on 
individual campuses and wellness cen-
ters have been conducted, there has been 
a lack of nationwide data on the younger 
18-to-24 year-old population in general. 
It wasn’t until recently that two Univer-
sity public health researchers took mat-
ters in their own hands.

University professors Kendrin Sonn-

eville and Sarah Lipson, assistant profes-
sors in nutritional sciences and health 
management and policy respectively, 
conducted a nationwide study on uni-
versity students with eating disorders. 
Published in 2017, the 9,713-person study 
aimed to determine risk profiles for eat-
ing disorders in a diverse population. 
The study measured the risks of students 
from various backgrounds to develop an 
eating disorder or disordered eating hab-

its with the long-term goal of taking pre-
ventive measures and improving current 
treatment.

Although eating disorders and dis-

ordered eating often result in physi-
cal symptoms, the disorder is a mental 
illness, characterized by an obsessive, 
unhealthy relationship with food. With 
the highest mortality rate among mental 
illness, eating disorders remain an insidi-
ous part of American culture. According 
to DSM-5, the Diagnostic and Statistical 
Manual of Mental Disorders published 
by the American Psychiatric Association, 
there are five categories of eating dis-
orders: anorexia, bulimia, binge-eating 
disorder, feeling or eating disorders not 
elsewhere classified (FED-NEC), and 
other eating disorders including body 
dysmorphic disorder (intrusive, imag-
ined or inaccurate perceptions of one’s 
body image) and orthorexia (the fixation 
on overly righteous eating habits).

Researchers are studying people who 

do not fit into the strict criteria of the 
DSM-5, but nonetheless have unhealthy 
relationships with food. Although these 
people do not have full-fledged eating 
disorders such as anorexia or bulimia, 
they are characterized as having sub-
clinical eating pathology, or “disordered 
eating,” which can develop into a clini-
cal disorder. Disordered eating affects a 
much larger population in college com-
munities and is now being targeted for 
earlier preventative measures.

“If you think about eating disorders 

like other conditions, it would be like 
saying, ‘We’re not going to treat you until 
you have stage 5 cancer.’” Sonneville 
said. “When you think about it that way, 
it doesn’t make any sense. There are early 
symptoms that if not addressed will prog-
ress to worse symptoms, and so Sarah 
and I took a public health approach. We 
looked at high levels of disordered eating 
behaviors that are themselves problem-
atic, but may actually progress if unad-
dressed.”

The study sought to observe other 

potentially 
influential 
characteristics 

like age, degree-level, gender, sexual ori-
entation, race and ethnicity, and citizen-
ship. After extensive analysis, the two 
researchers concluded undergraduate 
student status, non-straight men, and 
overweight or obese students were at the 
highest risk for developing an eating dis-
order.

“There’s been appreciation in my field 

of public health and descriptive epide-
miology about what is the face of eating 
disorders,” Sonneville said. “There’s this 
long-standing myth that eating disorders 
affect skinny, white, affluent girls. … We 
are seeing it across socioeconomic spec-
trum and across racial, ethnic groups. 
What we’re realizing is that the face 
of eating disorders — the stereotypical 
notion of what eating disorders look like 
— is not true.”

Sonneville and Lipson reported a 

startling 49 percent of female students 
engaging 
in 
binge-eating 
behaviors 

and 30 percent in men engaged in these 
behaviors. Female students were also 
more likely to engage in compensatory 
behaviors like food restriction and diet-
ing compared to men — 31 percent to 29 
percent.

“We wanted to get a sense of who is 

actually struggling and suffering on cam-
pus, because unless you understand who 
is suffering, it’s really hard to understand 
how you target early intervention, how 
you target prevention efforts,” Sonnev-
ille said.

Based on these findings, the two 

researchers urge universities to take pre-
ventative actions by conducting earlier 
and more regular eating disorder screen-
ings.

“What we found is that eating disorder 

pathology is really common on college 
campuses. We saw even smaller sex dif-
ferences than others find — with com-
pensatory behaviors like self-induced 
vomiting and compulsive exercising to 
be almost the same among males and 
females in our sample,” Sonneville said.

The ever-rising, incessant presence 

of social media in college culture often 
perpetuates the existing problem. The 
risks of exposure to idealized body types 
through social media is an emerging 
field of research. Bravender spoke about 
unrealistic body images being projected 
through media like Instagram.

“When we saw photoshopped or digi-

tally altered images 10 years ago, it was 
because a beauty company or fashion 
company or diet company was trying to 
sell us a product. Now, if we see a digital-
ly altered image, it might be our friends 
on social media using filters or other 
things,” Sonneville said. “It used to be 
for-profit industries that were trying to 
propagate this ideal, and now, we’re all 
trying to do it. That is a totally new phe-
nomena in eating disorder risk factors.”

Former U-M rower Traci Carson is 

now a Ph.D. candidate in the School of 
Public Health. Having personally expe-
rience with disordered eating, Carson 
spoke about the role of social media in 
her college and graduate school life.

“Being somebody that is constantly 

comparing myself to other people, I have 
seen how social media can be damag-
ing for my own thoughts about food and 
thoughts about my body,” Carson said. 
“In the last few months, I’ve made a con-

scious effort to make sure that the people 
I’m seeing on social media are not people 
who are feeding into my disorder. I will 
delete or unfollow people as soon as I 
see anything that triggers me to want to 
restrict or go exercise more or feel shame 
about the way that I look.”

Shannon Nulf, a School of Music, The-

atre & Dance freshman studying dance, 
echoed Carson’s sentiments. 

“When there’s a medium that’s usually 

edited, polished and filtered, I definitely 
think that plays into a mental self-loath-
ing. When you see all of this perfection 
in social media, that can mess with your 
head,” Nulf said.

She also spoke about the dangers of 

certain social media. Some contain blogs 
or accounts acting as instruction manu-
als for someone at risk or in the midst of 
an eating disorder. Nulf spoke about find-
ing information on specific social media 
sites that encouraged unhealthy habits 
and eating disorders.

“When I was in the throes of anorex-

ia, I was trying to find other people like 
me and see what I was doing,” Nulf said. 
She spoke about using social media sites 
like Tumblr to see how other people 
with anorexia were restricting their food 
intake and cutting weight—She often 
compared their methods to her own or 
looked for ideas on how to continue los-
ing weight. “There are Tumblrs on how 
to have an eating disorder. … It was all 
there for me, it was a resource that I wish 
I hadn’t had.”

Perhaps our next steps may involve 

using this pervasive medium to reach 
large groups of people and encourage 
more constructive ways of thinking about 
food. Bravender spoke about the dangers 
of teenagers and young adults viewing 
social media’s idealized body types as 
direct messages to them.

“If you’re looking at these Instagram 

feeds of perfection and you believe that 
that’s speaking to you and telling you 
how you should be, then it significantly 
raises your risk for developing an eating 
disorder,” Bravender said. “If you’re able 
to push that off to the side and be a savvy 
media consumer and realize that these 
perfect images aren’t possible and real-
ize they’re just images and just a brand 
someone is trying to sell you, then that 
doesn’t confer risk of an eating disorder.”

However, social media doesn’t seem 

to be entirely negative. Nulf and Carson 
raised similar ideas of filtering content 
by unfollowing or selectively choosing 
accounts. Kinesiology freshman Maddie 
Ross has proactively incorporated social 
media into her path to recovery, posting 
on an Instagram account the food she 
makes.

“I started this food Instagram account 

at the beginning of my recovery because 
I found other people who were in recov-
ery on Instagram,” Ross said. “There 
are nutrition blogs that focus on intui-
tive eating and health at every size. You 
have to find the positive pockets in social 

media, because there is so much negative. 
You have to realize where the negative is 
and put your blinders on when you see it 
or get away from it. It’s much easier said 
than done.”

Despite the abundance of these “com-

munication” channels for photos and 
videos, many illness narratives and expe-
riences are left untold.

Ross spoke about the onset of her 

anorexia when she was in middle school 
and high school.

“I felt like I had no control over my 

friendships or anything, but eating was 
the one place I could control. I thought 
that I was being healthy,” she said.

Nulf’s story followed a similar pattern 

of downward spiral and loss of control.

“It was all rooted in a big, body dys-

morphic view I had of myself. Then, it 
just spiraled and spiraled,” she said. “My 
hair started falling out and I just wanted 
to sleep. I started to fight with my friends 
and parents. I couldn’t sleep. I lost my 
period — a lot of medical effects.”

Students, myself included, are often 

unaware of exactly how ubiquitous the 
issue is. For how widespread and lethal 
the consequences are, the lack of dia-

logue on campus is striking.

“Eating disorders in general are dis-

eases of denial and secrecy,” Sonneville 
said. “There is shame, there is fear, there 
are a lot of underlying emotional things 
for someone who is actively struggling.”

Eating disorders, like other mental ill-

nesses, generally lack dialogue on cam-
pus, there is a smaller subpopulation 
within the community that is often over-
looked: athletes.

According to Bravender, there are 

three types of athletic endeavors that 
put students at particular susceptibility 
for developing eating disorders or disor-
dered eating.

The first group are athletes who may 

experience an initial improvement in 
performance from weight loss. These 
often include cross-country or long-dis-
tance runners.

“In people who are at risk, there’s a lit-

tle click that happens, and thinks, ‘Well if 
I lose five pounds and I improved a little 
bit, maybe if I lose 10 pounds I’ll improve 
more,’ and they try that,” Bravender said. 
“Of course, there’s a point of diminishing 
return, and as you lose more weight, your 
running 

ALEXIS RANKIN/Daily

Maddie Ross

ALEXIS RANKIN/Daily

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